Gregory Clinton Russell O.D.

NPI 1033144225 - Optometrist - 152W00000X

NPI Details
NPI 1033144225
Gender Male
Enumeration Date 07/12/2006
Last Updated 07/09/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
102 PROFESSIONAL PARK PVT DR
KINGSPORT TN, 37663-2287, US
Phone (423) 245-2222
Fax (423) 245-4822
Business Location
102 PROFESSIONAL PARK PVT DR
KINGSPORT TN, 37663-2287, US
Phone (423) 245-2222
Fax (423) 245-4822
Toxanomy
Taxonomy Code 152W00000X
License State Tennessee
License Number ODT1813
Remove 1033144225 NPI Number
 

According to our database, Dr. Gregory Clinton Russell O.D. NPI is 1033144225, taxonomy code is 152W00000X and license number is ODT1813, license state is located at Tennessee. Gregory Clinton Russell O.D. physically located at 102 Professional Park Pvt Dr, Kingsport TN, 37663-2287. NPI Number Gregory Clinton Russell O.D. has the Individual type.

Sponsored links

1033144225 NPI number is provided on an as is basis without warranty of any kind. 1033144225 is maintained by the National Plan & Provider Enumeration System. The contents of Gregory Clinton Russell O.D. are for informational purposes only.